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Myocardial Infarction: STEMI vs NSTEMI

Sajish Jacob
Medically reviewed by Sajish Jacob
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Sajish Jacob
Medically reviewed by Sajish Jacob

Myocardial Infarction

Within the realm of cardiac ailments, a singular term exists. It holds significant weight: Myocardial Infarction. But wait, there’s a twist! It comes in two varieties: STEMI vs. NSTEMI. Confused? Don’t worry. We’re here to solve the mystery.

Imagine this: Your heart is like a bustling city whose lifeblood is blood coursing through thoroughfares called arteries. Now imagine that one of those arteries is suddenly blocked, resulting in a heart attack. That’s where STEMI and NSTEMI come in. 

STEMI, the “big bang,” occurs when a significant artery becomes completely blocked. On the other hand, NSTEMI, a “sneak attack,” happens when a smaller artery is partially blocked. Understanding the difference between STEMI and NSTEMI is extremely important, as is knowing your opponent’s tactics in combat. So fasten your seatbelts as we delve into the intricacies of these cardiac culprits. Ready to dive into the heart of the matter? Let’s embark on this educational journey together.

The Difference Between STEMI and NSTEMI

Both conditions involve a blockage in the blood flow to the heart. There are significant differences between them. Understanding these differences is crucial for accurate diagnosis and appropriate treatment. Let’s explore the distinctions between STEMI vs. NSTEMI. It includes their causes, signs, diagnosis, and treatment options. Gaining a deeper understanding of these two types of heart attacks is vital. So, you’ll be better equipped to recognize the signs and seek prompt medical attention when needed.

STEMI (ST-Elevation Myocardial Infarction)

A complete blockage of a coronary artery generally characterizes STEMI. It is leading to significant damage to the heart muscle. This blockage is typically evidenced by persistent ST-segment elevation on an electrocardiogram (ECG). STEMI is generally considered a medical emergency. Also, it requires immediate reperfusion healing. This is thrombolytic therapy or percutaneous coronary intervention (PCI). It restores blood flow to the affected area of ​​the heart.

NSTEMI (Non-ST-Elevation Myocardial Infarction)

This condition occurs when there is a partial blockage or temporary disruption of blood flow in a coronary artery. It results in ischemia and myocardial damage. Difference between STEMI and NSTEMI may not present with significant ST-segment elevation on the ECG. Diagnosis often involves detecting cardiac biomarkers, such as troponin, which indicate myocardial injury. Treatment of NSTEMI may include medications. They help to ease signs, stabilize the patient, and prevent further complications. Cardiac catheterization and revascularization, depending on the severity of the condition, are helpful.

Is STEMI Worse than NSTEMI?

It is necessary to answer the question: is STEMI worse than NSTEMI? Both are forms of myocardial infarction (MI) and require urgent medical attention. They differ in several key aspects, including presentation, severity, and prognosis.

ST-Segment Persistent elevation on ECG May not present with significant elevation
Severity Considered more severe Generally considered less severe
Treatment Requires immediate reperfusion therapy Treatment may be more conservative
Risk of Complications Higher risk of complications and mortality Lower risk compared to STEMI
Prognosis Associated with higher mortality rates Generally better prognosis, but still serious

STEMI is typically associated with a complete blockage of a coronary artery. It is leading to significant myocardial damage and a higher risk of complications. They include cardiac failure, arrhythmias, and death. Immediate reperfusion treatment, such as thrombolysis or percutaneous coronary intervention (PCI), is necessary. It helps to restore blood flow and reduce myocardial damage. Despite advancements in treatment, STEMI remains a medical emergency. It has high mortality rates if not promptly managed.

So, is STEMI worse than NSTEMI? NSTEMI is usually characterized by a partial blockage or temporary obstruction of blood flow in a coronary artery. Still serious, it may not present with significant ST-segment elevation on the ECG. It is generally considered less severe than STEMI. Treatment of NSTEMI may involve medications. They help alleviate signs, stabilize the patient, and prevent further complications. Invasive procedures such as cardiac catheterization and revascularization may be necessary. Everything is significantly based on the severity of the condition.


Interpreting electrocardiogram (ECG) findings is crucial in distinguishing between STEMI and NSTEMI. It provides valuable information about the extent and severity of myocardial ischemia. An electrocardiogram guides treatment decisions and prognosis. To understand STEMI vs. NSTEMI ECG findings, check out our table:

T-Wave It may be usually elevated, inverted, or normal Often inverted or flat
Q-Wave May develop within hours of onset Absent or may develop later
R-Wave Progression Typically preserved or present It may be abnormal or absent
QT Interval Prolonged in some cases Usually typical or slightly prolonged
Other Changes Possible reciprocal changes in opposite leads Less pronounced or absent

Knowing the STEMI vs. NSTEMI ECG findings will help you to distinguish these conditions. In the first one, the ECG typically shows significant and persistent ST-segment elevation (>1mm) in two contiguous. It corresponds to the area of myocardial ischemia or injury. T-wave changes may accompany ST-segment elevation. Q-waves may develop within hours of symptom onset, indicating necrosis. R wave progression is usually persistent or present, and the QT interval may be occasionally prolonged. Reciprocal changes, such as ST segment depression in opposite leads, may also be.

In NSTEMI, ECG findings are often less pronounced compared to STEMI. ST-segment depression, flat, or transient changes may be present. Significantly, this section elevation is usually absent. T-wave changes, such as inversion or flattening, are common, and Q-waves are typically absent or may develop later. R-wave progression may be abnormal or lacking. The QT interval is usually average or slightly prolonged. Other changes, such as reciprocal changes, are less common or absent in NSTEMI.

Unstable Angina vs NSTEMI

Unstable Angina

Understanding the differences between unstable angina vs. NSTEMI is crucial. It helps to make an appropriate diagnosis and management. Both conditions present with chest pain suggestive of myocardial ischemia. Myocardial damage, indicated by elevated cardiac biomarkers, distinguishes NSTEMI from unstable angina. Prompt recognition and management of these conditions are essential. It helps to reduce the risk of complications and improve patient outcomes. Check out our table to manage with unstable angina vs. NSTEMI:

Aspect Unstable Angina NSTEMI
Definition Chest, rest pain, or minimal exercise indicates ischemia without myocardial injury. Chest pain or discomfort indicates myocardial ischemia. This is usually accompanied by signs of myocardial damage, as shown by elevated cardiac biomarkers.
ECG Findings May show transient ST-segment depression or T-wave inversion during episodes of chest pain. May demonstrate ST-segment depression or T-wave inversion, similar to NSTEMI.
Cardiac Biomarkers Troponin are typically standard. Elevated cardiac biomarkers such as troponin indicate myocardial injury.
Risk of Complications Generally, it is lower risk compared to NSTEMI and STEMI. Higher risk compared to unstable angina due to myocardial injury.
Prognosis Generally, it is a better prognosis compared to NSTEMI. The prognosis is worse than unstable angina due to myocardial injury.
Management Treatment focuses on symptom relief and risk factor modification. May require hospitalization for further evaluation and monitoring. Treatment involves aggressive management of ischemia and prevention of further myocardial injury. Hospitalization and invasive procedures may be necessary. Everything depends on the severity of signs and clinical findings.

Preventing STEMI and NSTEMI

Preventing STEMI

Knowing the difference between STEMI and NSTEMI and prevention strategies is pivotal. The emphasis on risk factor management, lifestyle modifications, and medication therapy remains paramount. It helps reduce the risk of both types of myocardial infarction. We have prepared for you a helpful table concerning prevention: 

Aspect STEMI Prevention NSTEMI Prevention
Blood Pressure Control Aggressive blood pressure control. It helps to prevent coronary artery disease and subsequent myocardial infarction. Blood pressure management is essential to prevent myocardial ischemia. It is vital for reducing the risk of cardiovascular events, too.
Smoking Cessation Such programs and support mitigate the risk of atherosclerosis and thrombotic events. Smoking cessation is a crucial component of prevention strategies. They aim to prevent cardiovascular disease.
Physical Activity Encouragement of regular physical activity to improve cardiovascular health. Also, it helps to prevent atherosclerosis. Regular exercise aims to improve cardiac function and reduce the risk of myocardial infarction.
Healthy Diet Promotion of a diet rich in fruits, vegetables, and whole grains. Lean proteins to maintain cardiovascular health. Dietary modifications include reducing saturated fats and cholesterol intake. They are essential for preventing atherosclerosis and myocardial infarction.


Understanding the distinctions between STEMI vs. NSTEMI is crucial. It helps with appropriate diagnosis and management, ultimately improving patient outcomes. Both conditions are forms of acute coronary syndrome. They differ in presentation, severity, and management. STEMI involves complete occlusion of a coronary artery. It is generally considered more severe, requiring immediate reperfusion therapy. NSTEMI is usually characterized by partial occlusion or temporary disruption of blood flow. It may present with less prominent ECG changes but requires prompt medical attention. 


Can you have both STEMI and NSTEMI?

Yes, it is possible to have both STEMI and NSTEMI. Different types of myocardial infarction may affect other areas of the heart.

Can lifestyle changes reduce the risk of STEMI and NSTEMI?

Lifestyle changes like a healthy diet and regular exercise can reduce the risk.

What is the timely treatment of STEMI?

Timely treatment of STEMI typically involves reperfusion treatment. It may be angioplasty or thrombolytic therapy to restore blood flow to the heart muscle.

Do you treat STEMI and NSTEMI the same?

The underlying treatment principles are similar. Specific management strategies may vary depending on the individual patient and clinical presentation.

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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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